CHRONIC CATARRHAL CONJUNCTIVITIS
‘Chronic catarrhal conjunctivitis’ also known as ‘simple chronic conjunctivitis’ is characterised by mild catarrhal inflammation of the conjunctiva.
Etiology
A. Predisposing factors
1. Chronic exposure to dust, smoke, and chemical irritants.
2. Local cause of irritation such as trichiasis, concretions, foreign body and seborrhoeic scales.
3. Eye strain due to refractive errors, phorias or convergence insufficiency.
4. Abuse of alcohol, insomnia and metabolic disorders.
B. Causative organisms
*� Staphylococcus aureus is the commonest cause of chronic bacterial conjunctivitis.
*� Gram negative rods such as Proteus mirabilis, Klebsiella pneumoniae, Escherichia coli and Moraxella lacunata are other rare causes.
C. Source and mode of infection. Chronic conjunctivitis may occur:
1. As continuation of acute mucopurulent conjunctivitis when untreated or partially treated.
2. As chronic infection from associated chronic dacryocystitis, chronic rhinitis or chronic upper respiratory catarrh.
3. As a mild exogenous infection which results from direct contact, air-borne or material transfer of infection.
Clinical picture
Symptoms
*� Burning and grittiness in the eyes, especially in the evening.
*� Mild chronic redness in the eyes.
*� Feeling of heat and dryness on the lid margins.
*� Difficulty in keeping the eyes open.
*� Mild mucoid discharge especially in the canthi.
*� Off and on lacrimation.
*� Feeling of sleepiness and tiredness in the eyes.
Signs.
Grossly the eyes look normal but careful examination may reveal following signs:
*� Congestion of posterior conjunctival vessels.
*� Mild papillary hypertrophy of the palpebral conjunctiva.
*� Surface of the conjunctiva looks sticky.
*� Lid margins may be congested.
Treatment
1. Predisposing factors when associated should be treated and eliminated.
2. Topical antibiotics such as chloramphenicol or gentamycin should be instilled 3-4 times a day for about 2 weeks to eliminate the mild chronic infection.
3. Astringent eye drops such as zinc-boric acid drops provide symptomatic relief.
OPTOMETRY-SHARP VISION
Optometrist